title: Impact of chronic constipation on health-related quality of life, work productivity, and healthcare resource use: an analysis of the National Health and Wellness Survey.
abstract: BACKGROUND
  There has been limited research addressing the effects of constipation on work productivity and healthcare resource use.
  
  
  OBJECTIVE
  To assess the effect of chronic constipation on health outcomes and healthcare resource use.
  
  
  METHODS
  Using data from the 2007 National Health and Wellness Survey (NHWS), chronic constipation patients (n = 1,430) were propensity score-matched to controls (n = 1,430) on demographic and clinical characteristics. Differences between groups in health-related quality of life (SF-12v2), work productivity and activity impairment, and resource use in the last 6 months were examined. Mediation analyses were conducted in order to determine whether the relationship between constipation and resource use was caused by a reduction in health status.
  
  
  RESULTS
  Chronic constipation patients reported significantly lower levels of health-related quality of life (physical component summary score: 39.57 vs. 43.73; mental component summary score: 43.19 vs. 47.86, all P-values < 0.01) and significantly higher levels of loss of work productivity and activity impairment (absenteeism: 9.08% vs. 5.20%; presenteeism: 29.52% vs. 19.09%; overall work impairment: 33.65% vs. 21.56%; activity impairment: 46.58% vs. 33.90%, all P-values < 0.01) compared to the matched controls. Chronic constipation patients also reported significantly more provider (7.73 vs. 5.63) and emergency room visits (0.52 vs. 0.30) in the past 6 months (all P-values < 0.01). Mediation analyses suggested that increased resource use among chronic constipation patients were partially a result of reduced health status.
  
  
  CONCLUSIONS
  Compared to matched controls, chronic constipation patients reported greater economic and humanistic burden. Alleviating the humanistic burden associated with constipation may have economic benefits.
authors.affiliation: Takeda Pharmaceuticals International, Inc., 1 Takeda Parkway, Deerfield, IL 60015, USA. shawn.sun@frx.com
authors.forename: Shawn X
authors.initials: SX
authors.lastname: Sun
authors.forename: Marco
authors.initials: M
authors.lastname: Dibonaventura
authors.forename: Fanta W
authors.initials: FW
authors.lastname: Purayidathil
authors.forename: Jan-Samuel
authors.initials: JS
authors.lastname: Wagner
authors.forename: Omar
authors.initials: O
authors.lastname: Dabbous
authors.forename: Reema
authors.initials: R
authors.lastname: Mody
mesh_terms: D002908:Chronic Disease; D003248:Constipation / Q000150:complications* / Q000191:economics; D004651:Employment; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life